New Approaches In Epidemiology And Treatment Of Depression: With A Case Report

Depression is one of the most prevalent disorders in the population. An estimated 20% of the general population will suffer depression sometime in their lifetimes. About 15% of patients with a mood disorder die by their own hand, and at least 66% of all suicides are preceded by depression. Depression is expected to be the second leading cause of disability for people of all ages by 2020. The causes of depression which include biological factor, genetic factor and psychosocial factor are complex. More than 40 years of research through experimental models and in the clinical setting have clearly indicated the importance of the monoamine neurontransmitters in the pathopyhsiology of depression. The main constituents of a multimodal antidepressant therapy are pharmacotherapy, psychotherapy and electric convulsive therapy, of which antidepressant drugs are the main choice. The current available antidepressants are classified according to their chemical structure and their mode of action. Currently, tri- and tetracyclic antidepressants, selective and non-selective inhibitors of the monoaminooxidase (MAOI), selective serotonin reuptake inhibitors (SSRI), selective noradrenalin reuptake Inhibitors (NARI) and antidepressants with a dual mode of action such as selective serotonin and noradrenalin reuptake inhibitors (SNRI), and noradrenergic and specific serotonergic antidepressants (NASSA).As the advances of the etiology of the depression , new pharmacological and nonpharmacological principles that possibly disclose novel perspectives in the treatment of depression. Regardless of the type of antidepressant drug, about 70% ofpatients with depression will respond to their medication, up to 15% of depression patients eventually present with treatment-resistant or refractory depression(TRD), and we will disscuss the definition, assessment, and staging of TRD.